U.S. Food Guide Pyramid food group intake by Asian Indian immigrants in the U.S.

This study examined the food group intake and the dietary quality of middle-aged and older Gujarati Asian Indian immigrants (45 years or older) living in two urban metropolitan areas in the U.S. Participants (90 men, 99 females) completed a 24-hour dietary recall, which was used to determine if they met the daily food group intake guidelines of the U.S. Food Guide Pyramid. The overall quality of their reported dietary intake was determined using the Healthy Eating Index based on their nutrient and food group intake. Both men and women met the daily number of servings recommendations for the grains (men: 9.3 servings/day; women: 6.9 servings/day) and vegetables (men: 4.5 servings/day; women: 3.6 servings/day) groups, but did not meet the recommendations for fruits, dairy and meats groups. The total score on the Healthy Eating Index of the diets of these participants was 73, indicative of a dietary intake that does not meet the established U.S. dietary guidelines. These immigrants should be educated about appropriate food choices (ethnic and non-ethnic) within each of the U.S. Food Guide Pyramid food groups to improve the overall quality of their dietary intakes.

Dietary practices, attitudes, and physiological status of collegiate freshman football players.

The purpose of this study was to determine the dietary practices, attitudes, and physiological status of freshman collegiate football players. Thirty-one freshman football players at a National Collegiate Athletic Association division I school completed a self-administered nutrition screening questionnaire designed to determine their dietary practices and attitudes. Fasting blood samples were collected and height and weight were measured. The mean age of these athletes was 18 years. These players reported eating 3.6 times per day and on the average eating out 4.8 times per week. Fast food was the most common choice when eating out (55%). Of these athletes, 42% reported the use of dietary supplements, the most popular one being creatine (36%). Although more than 90% of the athletes recognized the importance of maintaining proper hydration status, greater than 50% believed that protein supplements were necessary for muscle growth and development, protein was the primary source of energy for muscle, and vitamin and mineral supplements increased energy levels. The plasma lipid profiles of the majority (76%) of the athletes were within normal ranges. The data suggest that these athletes may require education about healthy dietary practices and on the proper use of dietary supplements. This is not only important to help improve performance but to also promote healthy dietary practices in the long term.

Dietary intake of elite figure skating dancers.

The main objective of the present study was to examine the dietary intake and physiological status of members of the US National Figure Skating Dance Team. Study participants included seven female and seven male figure skating dance pairs. Three-day food records were collected from each dancer and analyzed using a computerized nutrient database. Height, body weight and skinfold measurements were completed on each dancer. Body fat was estimated using the Jackson et al prediction equations. Fasting blood samples were collected for biochemical analysis. Total energy intake of female dancers (1416 kcal/d, 339 kjoules/day) was considerably lower than the dietary recommendations, while the male dancers appeared to have adequate energy intake (2837 kcal/d, 679 kjoules/day). Carbohydrate intake of both male and female dancers was below the recommendations, 44% and 51%, respectively, whereas total fat and protein intake of both male and female dancers were higher than the dietary recommendations. All dancers met at least 2/3(rd) of the dietary recommendations for all micro-nutrients, except folate and zinc intake of the female dancers, which were 68% and 62% of the recommended values. Although, blood lipid concentrations and other physiological parameters of the overall group were within normal ranges, two of the dancers (14% of the dancers) had elevated blood cholesterol concentrations and low iron status. The results of the present study suggest that these elite figure skating dancers, especially females, may not be consuming adequate amounts of energy-yielding nutrients and those that influence bone health. Future studies are needed to examine the effects of nutritional status on performance of these figure skating dancers and to develop strategies to improve the nutritional status of these elite dancers.

Assessment of under-reporting of energy intake by elite female gymnast.

This study examines the degree of under-reporting of energy intake by elite, female gymnasts, and the impact this predicted under-reporting has on associated macro and micro nutrient intake. Twenty-eight female U.S. national team artistic gymnasts participated in the study. Dietary intake was assessed using 3-day food records, and the degree of under-reporting was predicted from the ratio of reported energy intake (EI) to predicted basal metabolic rate (BMRestd), using the standards described by Goldberg et al. (10). Sixty-one percent of the subjects had an EI/BMRestd ratio of < 1.44, and were classified as under-reporters. The under-reporters had higher BMIs and percent body fat, and lower reported total energy intakes than the adequate energy reporters. Additionally, under-reporting of energy intake had a significant impact on reported micro nutrient intake. The under-reporting of energy intake seen in these subjects has an impact on the reported intake of macro and micro nutrients that can influence the interpretation of the nutritional status of these athletes and the strategy for nutrition intervention. Therefore, when assessing dietary intakes of elite gymnasts, some means of determining the accuracy of the reported energy and nutrient intake should be employed to more accurately identify the true nutritional problems experienced by these elite athletes.

Design, development, and formative evaluation of "put nutrition into practice," a multimedia nutrition education program for adults.

The purpose of this study was to design, develop, and formatively evaluate a computer-based multi-media nutrition education program for adults based on the Dick and Carey model of instructional design. The 4 phases of the study included analysis, design, development, and evaluation. Seventy-two volunteers from the US Air Force, aged 18 to 50 years, participated in focus groups, an E-mail survey, or a dietitian survey to establish the program's instructional goal of applying the principles of the Food Guide Pyramid to daily food choices. Objectives, assessment instruments, content, examples, and practice questions with feedback were written in the design phase. Four modules of instruction--Familiarization with Food Groups, Serving Sizes, Modifying a Menu, and Vitamins and Minerals--were programmed using Hyper-studio. Eighteen subjects aged 22 to 40 years, with at least a high school education and an average knowledge of nutrition volunteered to participate in 1 of 2 formative evaluation phases. All subjects completed a pretest, 2 posttests, 3 embedded tests, and an attitude questionnaire to ascertain program weaknesses. One module was deleted after phase 1 because the material lacked relevance to subjects. In phase 2, only 4 of 15 subjects could identify serving sizes in module 2 and only 6 of 15 subjects could do the same on posttest 1. Back buttons and review screens were added to modules 2 and 3 to facilitate identification of serving sizes. We conclude that dietetics professionals should use systematic models of instructional design, such as the Dick and Carey model, to design effective nutrition education programs for the public.

Accuracy of energy intake data estimated by a multiple-pass, 24-hour dietary recall technique.

OBJECTIVE: This study examined the accuracy of a multiple-pass, 24-hour dietary recall method for estimating energy intakes of men and women by comparing it with energy intake required for weight maintenance. DESIGN: Three-day, multiple-pass, 24-hour recalls were obtained on randomly selected days during a self-selected diet period when subjects were preparing their own meals and during a controlled diet period when all meals were provided by the study. During the dietary intervention, weight was maintained; body weight and dietary intake were monitored closely, thereby allowing estimation of the energy intake required for weight maintenance. SUBJECTS/SETTING: Seventy-eight men and women (22 to 67 years old) from the Dietary Effects on Lipoprotein and Thrombogenic Activity (DELTA) study participated in this study. All 24-hour recalls were collected using a computer-assisted, interactive, multiple-pass telephone interview technique. Energy requirements for each individual were determined by the energy content of the DELTA study foods provided to maintain weight. STATISTICAL ANALYSIS: Paired and independent t tests were conducted to examine differences among study variables. Agreement between recalled energy intake and weight maintenance energy intake was analyzed using the Bland-Altman technique. RESULTS: Compared with weight maintenance energy intake, during the self-selected diet period men and women underestimated energy intake by 11% and 13%, respectively. During the controlled diet period, men underestimated energy intake by 13%, whereas women overestimated energy by 1.3%. APPLICATIONS/CONCLUSIONS: Men had a tendency to under-estimate energy intake irrespective of the recording period. The accuracy of the recalled energy intake of women may be influenced by recording circumstances. Researchers should examine the factors influencing underreporting and overreporting by individuals and their impact on macronutrient and micronutrient intakes. Also, strategies need to be developed to minimize underreporting and overreporting.

A double-blind placebo controlled trial of oral midazolam as premedication before flexible sigmoidoscopy.

OBJECTIVE: We aimed to determine the efficacy of oral midazolam as premedication to improve tolerance of flexible sigmoidoscopy. METHODS: Ninety-nine patients were randomized to receive 7.5 mg of oral midazolam solution mixed with apple juice or placebo (apple juice), 20 min before sigmoidoscopy. Patients' anxiety and pain experienced before sedation, before the procedure, and during the procedure were assessed using a 10-cm visual analog scale (VAS) by both patients and physicians (0 = no pain, anxiety, 10 = severe pain, anxiety). Extent of sedation, amnesia, overall tolerance, adequacy of sedation, and willingness to repeat the procedure were assessed, and changes in vital signs and oximetries were recorded. RESULTS: Fifty-one patients received midazolam and 48 patients received placebo. Patients reported less pain and anxiety (VAS 2.56, 1.64) compared with placebo (VAS 4.62, 4.16) during the procedure (p < 0.005, p < 0.0005). Physicians observed less pain and anxiety (VAS 2.19, 1.52) with midazolam than placebo (VAS 5.00, 3.97) during the procedure (p < 0.0001, p < 0.0001). A significantly greater number of patients judged tolerance of the procedure to be "excellent" using midazolam (p < 0.005) compared with placebo. A majority of patients in both groups was willing to repeat the procedure if recommended. Two patients in the midazolam group had transient asymptomatic hypotension during sigmoidoscopy, but no patients were observed to have desaturation by oximetry. CONCLUSIONS: Oral midazolam significantly reduces anxiety and pain during flexible sigmoidoscopy as assessed by both patients and physicians. Oral midazolam is a safe and effective premedication before flexible sigmoidoscopy in patients who require or prefer sedation.

Comparative lipid and lipoprotein responses to solid-food diets and defined liquid-formula diets.

BACKGROUND: Liquid-formula diets (LFDs) are useful in metabolic studies of the cholesterolemic effects of dietary lipids because they can be formulated with accuracy, facilitating precise delivery of fatty acids of interest. However, because of differences in composition and nutrient delivery between LFDs and solid-food diets (SFDs), there is a need to determine differences in their effects. OBJECTIVE: Our objective was to compare lipid and lipoprotein responses to changes in total fat, saturated fatty acids (SFAs), and cholesterol in subjects consuming an SFD or LFD. DESIGN: Twenty-one healthy subjects consumed controlled diets representative of an average American diet [AAD; 37% of energy from fat (15% from SFAs), and <50 mg cholesterol/MJ] or a National Cholesterol Education Program (NCEP) Step II diet [26% fat (5% from SFAs) and <25 mg cholesterol/MJ]. Other nutrients were similar between diets. Diets were consumed for 23 d in a randomized, crossover design. RESULTS: For the AAD and NCEP Step II diet, there were no significant differences in lipids and apolipoproteins when the LFD or SFD versions were consumed. In contrast, consumption of the SFD was associated with significantly lower total cholesterol and triacylglycerols than was consumption of the corresponding AAD or Step II LFD (P < 0.05). Subjective ratings of satiety, hunger, and quality of life between diet forms did not differ significantly. CONCLUSIONS: Both LFDs and SFDs yield quantitatively similar cholesterolemic responses to changes in dietary fat, SFAs, and cholesterol. LFDs may offer advantages because they provide easily administered, complete, balanced nutrition without affecting satiety.

Sensory responses to fat are not affected by varying dietary energy intake from fat and saturated fat over ranges common in the American diet.

OBJECTIVE: To examine the effects of manipulating dietary fat in foods on sensitivity and hedonic response to fat in selected foods. DESIGN: Twenty subjects were randomly assigned to a sequence of three 8-week experimental diets (average American diet, step 1 diet, low-saturated-fat diet) that varied in energy from fat (37%, 30%, and 26%, respectively) and saturated fat (17%, 10%, and 6%, respectively). Subjects participated in sensory tests designed to assess their sensitivity to and liking for fat in several foods, before the study (baseline), after consumption of each diet, and after the study (washout). SUBJECTS/SETTING: Subjects were participants in the Dietary Effects on Lipoprotein and Thrombogenic Activity (DELTA) study. RESULTS: No significant differences were found among diets for difference thresholds (i.e., just noticeable differences) for fat in milk and pudding, ad libitum mixing of low- and high-fat samples of milk and soup, and hedonic scaling of fat concentrations in milk and muffins and of cheese, mayonnaise, hot dog, and pastry samples. APPLICATIONS/CONCLUSIONS: Within the dietary fat ranges and for the fat stimuli tested in this study, dietary fat as percentage of energy from fat and saturated fat was not a significant determinant of sensitivity to and/or liking for fat. Sensory factors should not be a barrier to the implementation of low-fat diets such as the step 1 and low-saturated-fat diets.

Perception of quality of life of persons with HIV/AIDS and maintenance of nutritional parameters while on protease inhibitors.

This descriptive study investigated quality of life issues, biochemical indices, and nutritional parameters of individuals with HIV/AIDS before the initiation of protease inhibitors (PI) and after PI therapy. Telephone interviews were conducted with 45 men and women who were diagnosed with HIV/AIDS. A 26-item subjective questionnaire was used to determine intake of liquid nutritional supplements, use of micronutrient and herb supplements, adherence to modified diets, gastrointestinal symptoms, employment status, sociability, and ability to conduct activities of daily living. A medical chart review was conducted to collect data on biochemical indices, weight, medication regimens, and incidence of opportunistic infections. The results of the study suggest that HIV/AIDS individuals gain weight, improve CD4 counts, and decrease HIV RNA viral load while on PI-based drug combination therapy. Opportunistic infections decreased, quality of life was improved, and blood albumin was elevated. Hyperlipidemia, that is, elevations in total cholesterol and triglycerides, was observed in study participants (44% and 40% of patients, respectively) after PI therapy. These findings support the need for future investigations to examine the long-term influence of PI-based combination drug therapies on nutrient intake, body composition, and quality of life of persons with HIV/AIDS.

Nutritional and physiological status of U.S. national figure skaters.

This study assessed the nutrient intake, body composition and biochemical indices of National Figure Skating Championship competitors. Four-day diet records, fasting blood samples, and anthropometric measurements were obtained 2 months after the National Championships from 41 figure skaters 11-18 years of age. Energy, carbohydrate, fat, dietary fiber and cholesterol intake were significantly lower compared to the NHANES III averages for adolescents in the U.S. In general, the mean intakes for most vitamins except vitamin D and E were above the recommended intake. But the athletes had lower intakes of vitamin E and B12, and higher intakes of vitamin C, and thiamin (females only) compared with NHANES III. The mean intakes of magnesium, zinc, and iodine by the male skaters were below the recommended levels, as were the mean intakes of calcium, iron, phosphorus, magnesium, and zinc by the female skaters. Also, the number of servings from vegetable, fruit, dairy, and meat groups were below the recommended levels. Biochemical indices of nutritional status were within normal limits for all skaters. But plasma electrolyte concentrations were indicative of potential dehydration status. The results suggest there is a need to develop dietary intervention and educational programs targeted at promoting optimal nutrient and fluid intakes by these athletes to maintain performance and improve long-term health status.

Energy and nutrient intakes of the United States National Women's Artistic Gymnastics Team.

The nutrient intakes and dietary practices of elite, U.S. national team, artistic female gymnasts (n = 33) were evaluated using 3-day food records. The gymnasts' reported energy intake was 43.4 kcal/kg (total 1,678 kcal/day), which was 20% below the estimated energy requirement. The contributions of protein, fat, and carbohydrate to total energy intake were 17%, 18%, and 66%, respectively. All reported vitamin intakes, except vitamin E, were above the RDA. The reported mineral intakes, especially calcium, zinc, and magnesium, were less than 100% of the RDA. The overall nutrient densities of the subjects' diets were higher than expected. Eighty-two percent of the gymnasts reported taking nonprescription vitamin and mineral supplements, and 10% reported taking prescription vitamin and mineral supplements. Forty-eight percent of the gymnasts reported being on a self-prescribed diet. Compared to NHANES III, the reported nutrient intake of these gymnasts was different from that of the average U.S. adolescent female. In summary, certain key nutrients such as calcium, iron, and zinc should be given more attention to prevent nutrient deficiencies and subsequent health consequences.

Successful therapy of bleeding duodenal varices by TIPS after failure of sclerotherapy.

Hemorrhage from duodenal varices may be severe and life threatening. We report a patient with portal hypertension and bleeding duodenal varices caused by cirrhosis of the liver. Endoscopic sclerotherapy and intravenous vasopressin failed to control bleeding in this patient. Hemorrhage was subsequently controlled by placement of a transjugular intrahepatic portosystemic shunt. We recommend that in patients with life-threatening hemorrhage from duodenal varices caused by cirrhosis of the liver, transjugular intrahepatic portosystemic shunt be considered in the management.

Evaluation of laminin peptide fragments labeled with indium-111 for the potential imaging of malignant tumors.

The laminin peptide fragments GYIGSR-NH2 and CDPGYIGSR-NH2 are known to bind to a 67-kDa laminin receptor. This receptors is understood to be expressed at higher than normal levels in malignant tumor cells, particularly those of breast and colon carcinomas. Peptides DTPA-GYIGSR-NH2 (1), DTPA-(GYIGSR-NH2)2 (2), DTPA-CDPGYIGSR-NH2 (3), DTPA-(CDPGYIGSR-NH2)2 (4), and negative control DTPA-GAGAGA-NH2 (5) were prepared by solid-phase peptide synthesis. All five DTPA-conjugated peptides were subsequently radiolabeled with 111In and their tissue distribution evaluated in mice bearing C3H tumors. 111In-3 and 111In-4 showed the highest specific tumor localization. These preliminary data support further study of radiolabeled petide fragments for the potential detection of malignant tumors of the breast and other organs.

Synthesis and biological evaluation of 1,1-dichloro-2,3-diarylcyclopropanes as antitubulin and anti-breast cancer agents.

Z-1,1-Dichloro-2,3-diphenylcyclopropane (1) is an effective anti-breast cancer agent in rodents and in cell culture. We recently determined that 1 inhibits tubulin assembly in vitro and causes microtubule loss in breast cancer cells, leading to accumulation in the G2/M portion of the cell cycle. Aryl ring-halogenated, methoxylated and benzyloxylated derivatives of 1, as well as its E-isomer and the dichlorocyclopropyl derivative of diethylstilbestrol (DES), were synthesized and tested for their ability to inhibit, the assembly of tubulin into microtubules. Including 1, 17 cyclopropyl compounds were tested. One (Z-1,1-dichloro-2-(4-methoxyphenyl)-3-phenylcyclopropane (12)) was found to be more active than 1. In addition, E-1,1-dichlorocyclopropylDES (17) was more potent than DES. The E-isomer of 1 (16) was inactive. The cytostatic activities of the compounds against MCF-7 and MDA-MB231 human breast cancer cells, and their abilities to perturb microtubules in MCF-7 cells were also evaluated. Z-Dichloro-2-(4-fluorophenyl)-3-phenylcyclopropane (5), Z-1,1-dichloro-2-(4-fluorophenyl)-3-(4-methoxyphenyl)cyclopropane (11), and Z-1,1-dichloro-2-(4-methoxyphenyl)-3-phenylcyclopropane (12) were more potent than 1 against the breast cancer cells.

Reducing saturated fat intake is associated with increased levels of LDL receptors on mononuclear cells in healthy men and women.

Studies with animal models suggest that saturated fatty acids raise low density lipoprotein (LDL)-cholesterol levels by reducing LDL receptor-mediated clearance. To examine this directly in humans, we studied the effects of lowering dietary saturated fat on LDL-receptor abundance in peripheral mononuclear cells which reflects hepatic LDL-receptor status. Healthy males and females (n = 25) participating in the DELTA (Dietary Effects on Lipoproteins and Thrombogenic Activity) Study consumed three experimental diets in a randomized cross-over design. Diets provided 34% fat, 15% saturated fatty acids (Average American Diet); 29% fat, 9% saturated fatty acids (Step-One Diet); and 25% fat, 6% saturated fatty acids (Low SAT Diet). Peripheral mononuclear cells were isolated from blood samples collected after 6 and 8 wk. An ELISA was used to quantify LDL-receptor protein in total cell membranes. LDL-receptor abundance increased by 10.5% after the Low SAT Diet (P < 0.05). This was associated with an 11.8% decrease in serum LDL-cholesterol (P < 0.05). A linear inverse relationship was observed between the percentage change in LDL-cholesterol and the percentage change in LDL-receptor abundance (r = -0.59; P < 0.01). In addition, LDL-receptor abundance also was correlated inversely (P < 0.001) with serum levels of LDL-cholesterol (r = -0.747) and apoB (r = -0.593). In summary, reducing dietary saturated fat is associated with an increase in LDL-receptor abundance of magnitude similar to the decrease in serum LDL-cholesterol. Thus, an important mechanism by which reductions in dietary saturated fatty acids decrease LDL-cholesterol in humans is through an increase in LDL-receptor number.